Category Archives: Evidence-based Medicine

Absence of evidence is not evidence of absence

An invisible unicorn has been grazing in my office for a month…Prove me wrong.
by Martin Burton, Evidently Cochrane

invisible-unicorn

An excellent blog on interpreting the findings from research evidence – the importance of effect size and an sufficiently large sample size from which to draw meaningful conclusions. In fact, caution is urged in drawing any firm conclusions from any one study. But what if there were a million people in each arm of a randomised clinical trial? Surely that is enough to be able to be sure that a treatment actually works or does not? The answer to that might surprise you…

“We can tell where it hurts, but can we tell where the pain is coming from or where we should manipulate?”

Hot off the press commentary in Chiropractic and Manual Therapies highlighting the challenges we (we = chiropractors, physiotherapists, osteopaths, GPs, orthopaedic and neuro-surgeons and any other healthcare professionals who manage neck/back pain) still face in the diagnosis and management of “non-specific” spinal pain.

What counts as evidence?

What counts as evidence – Backspace Vol 6 No 2 p28

This is a piece I wrote for Backspace, the newsletter of the European Chiropractors’ Union. It is mostly influenced by an article from the Journal of the Royal Society of Medicine (2009) which proposed a revision to Bradford-Hills’ ‘guideline for causation’ in relation to the assessment of research evidence. [My spelling of the principal author’s name is correct the first two times, “Howick” but for some reason best known to itself (to paraphrase Billy Connolly) I proceed to address him as “Howitz”! In the unlikely event that Dr Howick should ever read this please accept my apologies!] I recommend reading the paper by Howick et al (2009) and hopefully this article will whet your appetite to do so…